The schedule of attitudes toward hastened death - Measuring desire for death in terminally ill cancer patients

BACKGROUND, The authors examined the reliability and validity of the Schedu le of Attitudes toward Hastened Death (SAPID), a self-report measure of des ire for death previously validated in a population of individuals with the acquired immunodeficiency syndrome (AIDS), among terminally ill patients wi th cancer. METHODS. The authors interviewed 92 terminally ill cancer patients, all wit h a life expectancy of < 6 months, after admission to a palliative care hos pital. Patients were administered the SAPID, a clinician-rated measure of d esire for death (the Desire for Death Rating Scale [DDRS]), and several mea sures of physical and psychosocial well-being. RESULTS. The average number of SAPID items endorsed was 4.76 (standard devi ation, 4.3); 15 patients (16.3%) endorsed greater than or equal to 10 items , indicating a high desire for death. Internal consistency was strong (coef ficient alpha = 0.88, median item-total correlation = 0.49), as were indice s of convergent validity. Total SAPID scores were correlated significantly (correlation coefficient [r] = 0.67) with the DDRS, and somewhat less so wi th measures of depression (r = 0.49) and hopelessness (r = 0.55). Lower, bu t substantial, correlations were observed between the SAPID and measures of spiritual well-being (r = -0.42), quality of life (r = -0.36), physical sy mptoms (r = 0.38), and symptom distress (r = 0.38). No significant correlat ion was observed between SAPID scores and social support (r = -0.06) or pai n intensity (r = 0.16); however, pain-related functional interference and o verall physical functioning were correlated significantly with SAPID scores (r = 0.31 and r = -0.23, respectively). CONCLUSIONS. The SAPID appears to be a reliable and valid measure of desire for death among terminally ill cancer patients. Coupled with previous rese arch in patients with AIDS, these results support the utility of the SAHD f or research addressing interest in hastened death in patients with a life-t hreatening medical illness. (C) 2000 American Cancer Society.